Friday, May 7, 2021

Presedintele Iohannis spune ca Romania sta "extrem de bine" cu vaccinarea anti-covid, dar realitatea este alta (RO)

 Anuntul triumfalist de ieri al presedintelui Iohannis cum ca, spre deosebire de multe alte tari, Romania sta "extrem de bine" in privinta campaniei de vaccinare anti-covid este inselator.

Exista un singur aspect la care Romania este acum intr-o situatie mai buna decat alte tari europene, si anume faptul ca a obtine un vaccin a ajuns sa fie mult mai usor: nu mai exista conditii de varsta sau de comorbiditate, nu mai este nevoie de programare prin sistemul centralizat, pur si simplu oamenii se pot prezenta spontan la centrele de vaccinare deschise, exista destule doze de vaccin pentru toti.

Fara indoiala, acesta este un lucru foarte important din punctul de vedere al individului care isi doreste vaccinul. In tarile occidentale, programarile sunt inca restrictionate pe categorii de varsta, de exemplu tinerii fara anumite comorbiditati mai au de asteptat, posibil chiar luni intregi.

In schimb, din punctul de vedere al situatiei vaccinarii si al obiectivelor ei asumate (atingerea unei imunitati colective a populatiei si prevenirea sau atenuarea semnificativa a viitoarelor valuri ale pandemiei), Romania sta foarte prost comparativ cu alte tari europene. Iar succesul relativ in disponibilitatea vaccinurilor pentru cei doritori mascheaza de fapt o mare problema, care este pe cale sa duca la esecul campaniei de vaccinare.

Pentru a lamuri situatia, este suficient sa privim indicatorii-cheie ai progresului vaccinarii in tarile Uniunii Europene.

Monday, April 12, 2021

Este Romania prea rigida in administrarea dozei a doua de vaccin anti-covid? Statistici, explicatii, interpretari... (RO)

Romania a inceput relativ bine campania de vaccinare anti-covid, fiind de-a lungul lunii feburarie printre primele tari din UE ca numar de doze de vaccin administrate la suta de locuitori. Dar la sfarsitul lunii februarie a franat brusc ritmul vaccinarii, fiind ajunsa din urma de media UE. A mers apoi in pas cu media UE pana in ultima saptamana a lunii martie, cand Romania a inceput sa ramana tot mai mult in urma mediei la dozele administrate - nu ca ar fi incetinit, ci pentru ca celelalte tari au accelerat semnificativ, in timp ce tara noastra a ramas intr-o viteza 'de croaziera' de cca. 55.000 de doze de vaccin administrate zilnic (spre comparatie, Franta, care a inceput mult mai incet in ianuarie, a ajuns recent la peste 500.000 de doze pe zi, cu o populatie doar de 3 ori si jumatate mai mare decat a Romaniei).

Graficul de mai jos al numarului de doze de vaccin administrate la suta de locuitori ilustreaza aceasta evolutie in trei acte: Romania deasupra mediei UE in februarie, in pas cu media UE in martie, si ramanand din ce in ce mai mult in urma de atunci.


Aceasta ramanere in urma nu este deocamdata dramatica. Chiar daca Romania este acum printre tarile din UE cele mai intarziate cu vaccinarea, inca nu a pierdut contactul cu plutonul si mai poate recupera daca accelereaza campania de vaccinare in perioada urmatoare, mai ales ca in tara au intrat pana acum doze destule (cu peste 2 milioane mai multe decat numarul dozelor deja administrate). Penuria de vaccinuri, care s-a manifestat acut in februarie, nu mai este acum o problema - exista doze suficiente pentru a accelera semnificativ vaccinarea.

Dar exista o diferenta in campania de vaccinare din Romania fata de alte tari UE care merita discutata, pentru ca ar putea avea implicatii importante in depasirea mai rapida, sau dimpotriva, agravarea si prelungirea actualului val al pandemiei. 

Diferenta dintre Romania si 'mainstream-ul' european este ilustrata de faptul ca, desi se afla sub media UE la numarul de doze administrate (raportat la populatie), Romania este totusi sensibil peste media UE la proportia celor complet vaccinati (care au primit ambele doze de vaccin):



Cu alte cuvinte, Romania a administrat mai putine doze de vaccin la suta de locuitori, dar are mai multi complet vaccinati (adica a administrat a doua doza in proportie mai mare decat media UE).

Care este explicatia acestui aparent paradox si ce inseamna acest lucru?

Monday, March 22, 2021

Cutting through the noise on vaccines, some counter-intuitive truths (EN)

Without false modesty, this blog has been ahead of the curve on the AstraZeneca (AZ) covid vaccines affair. It exposed almost two months ago the arrogant lies of Pascal Soriot, AZ's CEO, in his attempts to bamboozle the EU into accepting that it should be treated as a second-class client, hinted at the likely foul play by the UK Government and at the toxic mix with Brexit politics. By March, statements made here - e.g. on the de facto vaccine export ban instituted by the UK or on the need to limit exports to ensure that AZ is serving fairly its EU contract - were part of the line taken by senior EU officials, such as European Council President Charles Michel, or European Commission President Ursula von der Leyen

On the other hand, this blog didn't hesitate to call out the ineptitude of some national leaders' comments on the AZ vaccine and of some national regulators' decisions on its roll-out - a stupidity compounded by last week's temporary suspension of the vaccine in almost half of the Member States, based on mainly political considerations, in spite of the advice of EU's own regulator. And it also criticised the Commission's short-lived intention to invoke Art.16 of the Northern Ireland protocol as a very consequential political gaffe, which gave a pretext for the UK to try to wriggle out of its legal obligations.

As the vaccine-related escalation between the EU and the UK is now in full swing, the ongoing war of narratives creates a lot of noise that can easily distract from the fundamentals. It's therefore timely to take a step back, look at the bigger picture and scratch a bit the surface to bring up some rather counter-intuitive insights. 

I will try to argue that:

  • the AZ (and broader covid vaccines) scandal is more of a political stake than an actual public health issue; 
  • in the medium term the EU's problem is not the shortage of vaccines, but a very different one;
  • UK's apparent triumph on the vaccines is far from vindicating Brexit, rather the contrary; and 
  • the EU is very well positioned for success in the longer term, but only if it manages to overcome its existential challenges in the short term.

Thursday, March 18, 2021

Can vaccination prevent new lockdowns in Europe? (EN)

Back in January, in the second part of this post, I anticipated that EU countries were facing an imminent, devastating third wave of the pandemic over the coming months, driven by the more contagious mutations of the virus. I also wrote that the vaccines roll-out, even if proceeding according to plan (which it hasn't, mainly due to AstraZeneca's failure to supply on its contract with the EU), would not be able to help flatten the curve - they were simply too little, too late for this wave.

In the meantime, much of the talk in Europe has been about gradually lifting restrictions introduced at the beginning of winter. 

But one and a half month later, as more and more countries see again their infections and deaths going up again (below figure from ECDC) and their hospitals under strain, the tone is changing and re-confinement is back on the table across Europe.



The lingering question is: would a faster vaccination have helped significantly mitigate this new wave of the pandemic, so as to avoid renewed lockdowns? 

It's a legitimate question, especially as one compares with the UK, which, having achieved a much higher vaccination rate than continental Europe, is seeing its case count fall and is preparing to emerge from lockdown.

And linked to this, what is the level of vaccination where one can hope to see, if not 'herd immunity' (which we know requires around 70% of people to be immune), at least a meaningful impact on the virus propagation, a noticeable 'flattening of the curve' without the need for tough lockdown-type restrictions?

By looking at the available evidence from different countries with different levels of vaccination and at different points in the pandemic wave, the answer to the first question is, sadly, that even a flawless vaccination rollout wouldn't have avoided the need for fresh lockdowns in Europe.

The answer to the second question is more complicated and depends on a number of other factors (e.g. how many people in a given country already have some immunity after having been infected with covid in the earlier waves), but it points to a level of vaccination that EU countries are very unlikely to reach before summer. So if vaccination can help Europe re-open safely and broadly, this might only be the case from next autumn.

Thursday, February 18, 2021

As Britain's cheating on vaccines is revealed, the EU has a duty to react (EN)

There isn't much to add to CNN's revelations about UK's contract with AstraZeneca (AZ) for on covid-19 vaccines, but it's worthwhile summarising the main facts:

  • The British authorities have been apparently trying to keep the deal with AZ as a national security secret, but inadvertently made it available online back in November last year.
  • UK's contract with AZ is very similar to EU's contract, in particular with regard to the "best reasonable efforts" clause. 
  • UK's contract with AZ is officially dated one day after EU's contract with the company.
  • The British contract also mentions that vaccines can be delivered from production sites in the EU, just like the EU contract also lists production sites in the UK.
In brief: no significant difference between the two contracts, whether in respect to the "best reasonable efforts" clause, to the time of concluding the contracts (only a day's difference, with EU's the earlier one) or to the sourcing of the promised supply.
These are explosive revelations and the implications deserve a discussion.

Thursday, February 4, 2021

On vaccines, Europeans are shooting themselves in the foot... again (EN)

After the European Commission's blunder on invoking - even briefly for a couple of hours last Friday - Article 16 of the Northern Ireland protocol, which offered a golden opportunity to the UK to pressure the EU into making further post-Brexit accommodations, the Europeans are again scoring an own goal in the vaccines saga.

This time it's not so much about Brussels, but about national leaders and authorities.

The decision by several countries (Germany, France, Portugal, Sweden, Austria, Poland, Belgium... and counting) to limit the use of the Oxford/AstraZeneca covid vaccine to those under 65 (or even under 55 in one country), compounded by statements such as this one by French president Emmanuel Macron, is a big mistake and an act of self-harm on many levels.

It is wrong on the facts. It undermines the EU vaccination strategy and the countries' own vaccination efforts. And it weakens the legal case that the EU has against AstraZeneca for non-performance of their contract to supply vaccines.

Sunday, January 31, 2021

Who is the bully now? (EN)

Since I posted yesterday about the escalation of the covid vaccine row between the EU and the UK, events have taken an even uglier turn.

There is no doubt that the EU is on the defensive after its blunder Friday on the Irish border, even if it reversed it within hours (see a more elaborate explanation in my yesterday's post... not such an outrage really, but an extremely bad move politically). But the humiliation of the EU that is feasted in British media and partly across the continent these days doesn't serve any good purpose. It is mostly driven by schadenfreude and fundamentally wrong. And the righteousness and hypocrisy of the British establishment are becoming unbearable.

The EU is presented as the villain from having attempted - in the face of a desperate shortage due to pharma companies reneging on their commitments - to protect its EU-made contracted vaccine supplies from the diversion to other countries. Meanwhile, the UK itself is operating a de facto export ban on AstraZeneca (AZ) vaccines manufactured on its territory, pretending that it has a right to monopolize the supply because it signed a contract earlier, notwithstanding AZ's contractual obligation to also supply the EU from its UK-based factories.

It now transpires that in addition to AZ having shipped EU-made vaccines to the UK last year, Pfizer also has been sending significant quantities to the US, while both companies are failing to deliver to the EU on their contracts. The EU is thus punished not for being slow, but for having leveraged its collective bargaining power to obtain the cheapest prices.

The UK "generously" offers to allow AZ to deliver vaccines to the EU... once it has finished inoculating all its adult population, sometime in autumn. Meanwhile the EU is entering the third wave of the pandemic with very low immunisation rates due to a combination of a slow start vaccination process across its 27 member states and insufficient delivery by the vaccine providers - Pfizer and AZ.

Righteousness and hypocrisy are in even sharper display when it comes to the Irish border. The EU is universally condemned for having announced (and quickly reversed) the activation of Article 16 of the Norther Ireland protocol of UK's Withdrawal Agreement, with a view to prevent backdoor export of vaccines to the UK. But that Article 16 is part of the protocol - so invoking it cannot be construed in any way as a breach of the protocol. Again, as I also wrote yesterday, getting anywhere near Article 16 was a political gaffe... but certainly not an "incredible act of hostility" as Arlene Foster presented it. If invoking Article 16 amounts to a quasi-declaration of war, why was it stipulated in the protocol in the first place?

What was, indeed, an incredible act of hostility were the UK Government's plans, last year, to override the Northern Ireland protocol by creating a different and contradictory legal framework through its proposed Internal Market act (abandoned in the meantime).

But why would British politicians, especially on the tory and DUP side, feign unlimited outrage? Part of the motivation is to change the narrative from last year and present the EU rather than the UK as untrustworthy to uphold its commitments. But more importantly, because they want to use this opportunity to abolish the Northern Ireland protocol altogether and wriggle out of the agreement that they ratified. 

Who is the bully now?

Make no mistake: the public shaming of the EU for the sin of having stood up for itself in the covid vaccines scandal - admittedly having got it wrong politically and subsequently backpedaling on the issue of controlling the Irish border - is not a legitimate reaction born out of genuine outrage. It is a deliberate drive to humiliate and bully the EU in the context of post-Brexit politics, with the ultimate aim to vindicate Brexit.

Saturday, January 30, 2021

The dangerous escalation between the EU and the UK on covid-19 vaccines (EN)

The snowballing developments over the past few days, after AstraZeneca (AZ) announced a significant cut in its scheduled supplies of covid-19 vaccine to EU countries, have escalated to a war-like rhetoric between the UK and the EU, a raid by Belgian authorities at the AZ production site in Seneffe and the introduction of export controls on EU-manufactured vaccines. What's happening, really, and where is this coming from?

The narrative in the media about these events has been so far surprisingly simplistic and one-sided - not just in British tabloids like The Daily Mail, but also in usually much more sober outlets like The Guardian or the BBC and in many continental newspapers. It basically says that, due to its well-known bureaucratic heaviness, the EU was late to pass contracts with vaccine suppliers, slow with approving and distributing the jabs for use in its Member States and ineffective in the whole set-up of the vaccination campaign, which is in shambles. By contrast, the UK has been much nimbler with both purchases and approvals and as a result is way ahead of continental Europe with its vaccination efforts. Faced with a shortfall in vaccine supply, the EU has been throwing its weight around and trying to bully Britain into surrendering its own stocks. 

It's fair to say that, at least for the time being, the EU is losing the narratives' war.

The actual story, however, might be considerably more complicated. 

In this post I will present an alternative interpretation, largely based on information in the public domain, but also in part on speculation since some pieces of the puzzles are still missing. The near future may shed light on these aspects.

In a nutshell, my hypothesis is that the escalation is not simply due to the EU bureaucrats having 'lost the plot', but rather provoked by the conduct of AZ and of its CEO (which has been the immediate trigger for the crisis) and by perceived foul play from the UK on a very sensitive, politically explosive issue. 

All parties have made mistakes and the situation is getting out of hand. The stakes are huge and the logic is increasingly that of a zero-sum game, which risks durably poisoning the post-Brexit relations.